Assessment of Preterm Infants Using the Bayley-III Scales in Korea

OBJECTIVE: To assess the well-being of preterm newborns using the Bayley-III scales in a Korean-based population, and to evaluate the perinatal risk factors influencing developmental outcome. METHODS: Using the Bayley-III scales, we assessed 120 preterm infants who were referred for evaluation of neurodevelopmental performance. We subdivided them into an extremely preterm group (n=18) and a very/moderate to late preterm group (n=102). Bayley-III mean scores and the rate of infants showing a delay were compared for both groups. The relationship between perinatal risk factors and Bayley-III scores was analyzed. The risk factors were considered as very low birth weight, history of neonatal medical problems, and abnormal radiologic findings in brain magnetic resonance images (MRIs). RESULTS: Although no significant differences in mean scores were observed between the extremely preterm group and the very/moderate to late preterm group, the rate of babies showing developmental delay in motor composite scores was significantly higher in the extremely preterm group. The proportions of preterm infants with cognitive, language, and motor delays were 38.3%, 26.7%, and 35.0%, respectively. Very low birth weight was a significant risk factor for low cognitive, language, and motor composite scores. Also, abnormal radiologic findings on brain MRI were significant indicators of lower motor composite scores. CONCLUSION: Cognitive development was the most frequently delayed domain in preterm infants and motor development was more frequently delayed in the extremely preterm group. The very low birth weight and abnormal radiologic findings in brain MRI were predictive factors for neurodevelopmental outcome.

Influencia de la prematurez en el desarrollo de la comunicación / Prematurity influence in the development of communication / Influência da prematuridade no desenvolvimento da comunicação

Introducción: dentro de las alteraciones del neurodesarrollo, la prematurez es un factor de riesgo. Los niños prematuros tempranamente pueden presentar retraso en la comunicación y lenguaje, comparados con la población general. Objetivos: Dar a conocer la influencia de la prematurez en el desarrollo de la comunicación y el abordaje posible a realizar. Material y métodos: Análisis de 59 historias clínicas de niños prematuros que asistieron a control y seguimiento en el Gabinete de Intervención Temprana del Hospital Argerich, desde enero de 2011 hasta enero de 2017; y Escala Bayley del Desarrollo Infantil aplicada a cada niño, contemplando habilidades comunicativas y lingüísticas. Resultados: De las habilidades comunicativas esperadas para cada rango de edad, los diversos grupos (6, 9, 12, 18 meses de edad corregida) no alcanzaron a completar el 50% de las mismas. Analizando los resultados de cada grupo de prematuros (Extremo, Muy, Moderado y Tardío), se encontró que a medida que aumenta la edad gestacional existe un aumento de porcentaje de puntuación menor a dos desvíos estándar, visualizado a partir de los 9 meses de edad corregida, presentando compromiso cognitivo general y no sólo del lenguaje. Conclusiones: La prematurez afecta el desempeño comunicativo de los niños. La intervención fonoaudiológica temprana y el desarrollo de dispositivos de estimulación de comunicación y lenguaje contribuirían a disminuir el impacto que puede tener en el desarrollo global de los niños, favoreciendo la intra e intercomunicación, desde los primeros meses de vida.

Introduction: within neurodevelopmental disorders, prematurity is a risk factor. Also, premature infants, may have delays in language and communication acquisition compared to the general population. Objectives: Present the influence of prematurity in the development of communication and the possible approach to be performed. Material and methods: Analysis of 59 clinical records of premature infants, who attended control and follow-up at the Argerich Hospital Early Intervention Service, from January 2011 to January 2017; And Bayley's Scale of Child Development applied to each child, contemplating communicative and linguistic skills. Results: Of the communicative skills expected for each age range, the various groups (6, 9, 12, 18 months of age corrected) fail to complete 50% of the same. Analyzing the results of each group of premature infants (Extreme, Very, Moderate and Late), it was found that as gestational age increases, there is an increase in percentage of score less than two standard deviations observed after 9 months of age corrected, presenting general cognitive commitment and not just of the language. Conclusions: Prematurity affects the communicative performance of children. Early speech therapy and the development of language and communication stimulation devices, would contribute to reduce the impact that can have on the global development of children, favoring intra and intercommunication, from first months of life.

Introdução: dentro das alterações do neurodesenvolvimento a prematuridade é um fator de risco. Os prematuros podem ter atrasos na aprendizagem da linguagem, em comparação com a população em geral. Objetivos: Apresentar a influência da prematuridade no desenvolvimento da comunicação e sua possível abordagem. Material e métodos: Análise de 59 histórias clínicas de infantes prematuros que participaram do monitoramento e acompanhamento no gabinete de intervenção precoce do Hospital Argerich, de janeiro de 2011 à janeiro de 2017; a escala Bayley de crianças em desenvolvimento aplicada a cada criança, contemplando as habilidades comunicativas e lingüísticas. Resultados: Entre as habilidades comunicativas esperadas para cada facha de etária, os diversos grupos (6, 9, 12, 18 meses de idade corregida) não chegam a completar 50% dessas habilidades. Analisando os resultados de cada grupo de prematuros (extremo, muito, moderado e tarde), encontramos que a medida que aumenta a idade gestacional existe um aumento da porcentagem na pontuação menor a dois desvios estândar, observado a partir dos 9 meses, apresentando compromisso cognitivo general e não somente da linguagem. Conclusões: A prematuridade afeta o desempenho comunicativo de crianças. A intervenção fonoaudiológica precoce e o desenvolvimento de dispositivos de estimulação da linguagem, ajudaria a diminuir o impacto que pode ter sobre o desenvolvimento global das crianças, favorecendo a intra e intercomunicação a partir dos primeiros meses de vida.

The effect of liver transplantation on the neurocognitive function of children with biliary atresia / 中华器官移植杂志

Objective To observe the mental and motor development of children with biliary atresia before and after liver transplantation,and analyze the effect of liver transplantation on neurocognitive functions.Methods Fifty children with biliary atresia who experienced living related liver transplantation were selected from Jan.2016 to Dec.2016 in our hospital,with an average age of 5 to 12 months regardless of gender.All the children were assessed by Bayley Scale of Infant Development (BSID) one day before surgery,to obtain the mental and motor development conditions.The results were indicated with Mental Development Index (MDI) and Psychomotor Development Index (PDI).The levels of preoperative ammonia,bilirubin,albumin and white blood cells were recorded,and their relationship with preoperative neurocognitive development was analyzed.The development indexes were obtained at 2nd week,3rd week and 1st month after surgery by the same method,and the neurocognitive changes were analyzed in children before and after the surgery.The effects of postoperative biliary complications,secondary operations,pneumonia infection and other complications on the postoperative development indexes one month after surgery were assessed.Results The preoperative mental and motor development was both below the standard level in 50 infants with average MDI and PDI in middle and lower state.The correlation analysis among the levels of preoperative blood ammonia,bilirubin and albumin showed statistically significant on development index (P ＜ 0.05).The levels of blood ammonia and bilirubin were negatively correlated with development index,while albumin levels showed a positive correlation.As compared with one day before liver transplantation,MDI and PDI were decreased at 2nd week after operation;the MDI increased,and PDI had no significant change at 3rd week after operation.MDI and PDI were significantly higher at 1 st month after operation than preoperation.As compared with 2nd week after operation,PDI and MDI were significantly increased at 3rd week and 1st month after operation.Postoperative persistent pneumonia infection could affect children's MDI,and biliary complications could affect PDI (P＜0.05).Concision The mental and motor development conditions of children with biliary atresia were in medium/low level,and the levels of preoperative blood ammonia,bilirubin and albumin may have significant influence.Liver transplantation may obviously improve the patient's neurocognitive function.

Desarrollo psicomotor en niños de nivel socioeconómico medio-alto / Psychomotor development among children of upper-middle class in Chile

Objective: Describe the psychomotor development (PMD) in upper middle class children, utilizing Bayley's Scale of Intellectual Development (BSID), internationally standarized. Patients and Methods: A total of 119 children in groups of 8, 18 and 30 months were enrolled at the well-baby clinic in a Private Hospital in Santiago, Chile. BSID III was utilized in all cases. Children born preterm, or with neurological, genetic, or metabolic diseases were excluded. Results: BSID scores followed a normal distribution (100.3 +/- 10). Prevalence of déficit was found to be 30%) at 8 months, 7.7%> at 18 months, and 2.7%> at 30 months, without gender difference. Gross motor development and language predominated at 8 months. Ther threee subscales showed an upward trend, cognitive and motor scales most significantly. Gross motor scales, which had been deficient at 8 months became normal at 18 months. Conclusions: The high frequency of motor deficits found at 8 months of age was striking. While all scales improved, cognitive and motor scales were most significant. The effect of stimulation and upbringing patterns upon chil development is discussed, being important for future studies of causality.

Objetivo: Describir los puntajes de desarrollo psicomotor (DSM) en niños sanos de nivel socio económico medio alto mediante la Escala de Bayley de Desarrollo Infantil (BSID), estandarizada internacionalmente. Pacientes y Métodos: Estudio transversal descriptivo. Se enrolaron 119 niños 8, 18 y 30 meses, que acudieron a control sano en una Clínica privada de Santiago de Chile, para la aplicación de BSID III. Se excluyeron los nacidos de pre-término o con enfermedad neurológica, genética o metabólica conocida. Resultados: Los puntajes obtenidos en BSID siguieron una distribución normal (100,3 +/- 10). La prevalencia de déficit en el DSM fue 30% a los 8 meses, 7,7% a los 18 y 2,7% a los 30 meses, no hubo diferencia por sexo. A los 8 meses predominó el déficit motor grueso y posteriormente el lenguaje. Las tres subescalas mostraron una tendencia al alza, las áreas cognitiva y motriz siguieron una progresión significativa. La motricidad gruesa, que estaba en el rango inferior a los 8 meses, fue normal a los 18. Conclusiones: Destaca la alta frecuencia de déficit motor en la población evaluada, especialmente a la edad de 8 meses. Todas las subescalas mostraron una tendencia al alza, siendo ésta diferencia significativa en las áreas cognitiva y motora. Se discute el efecto de la estimulación y los patrones de crianza en el desempeño de los niños, siendo necesario planificar estudios prospectivos para conocer su relación de causalidad.

Assessment of children with developmental delay: Korean infant and child development test (KICDT) and Korean Bayley scale of infant development-II (K-BSID-II) / 소아과

PURPOSE: We aimed to compare the effectiveness of 2 developmental tests-Korean Infant and Child Development Test (KICDT) and Korean Bayley Scale of Infant Development-II (K-BSID-II)-in the assessment of children with developmental delay. METHODS: Twenty-eight children with suspected developmental delay, who visited the Department of Pediatrics in Asan Medical Center from February 2007 to June 2008 were enrolled. They were examined using both KICDT and K-BSID-II. The results of the tests were compared on the basis of 2 parameters: age group of the children and detection of organic brain lesion on magnetic resonance imaging (MRI). The correlation between the results of the 2 tests was analyzed using SPSS. Further, intraclass correlation coefficient was calculated using SAS to examine consistency between the results of the 2 tests. RESULTS: The mental developmental index of K-BSID-II showed significant correlation with every KICDT score (P<0.01). The psychomotor developmental index of K-BSID-II was also significantly correlated with every KICDT score except the fine motor score (P<0.01). The mental developmental index of K-BSID-II showed significant correlation [Editor20] with the KICDT gross motor, fine motor, and language scores (P<0.05). Further, there was significant correlation between the psychomotor developmental index of K-BSID-II and the KICDT gross motor score (P<0.05). CONCLUSION: There was significant [Editor21]correlation between the results of KICDT and K-BSID-II for infants and children with developmental delay. Although our results suggest that KICDT is useful in assessing developmental delay, further research would be needed to standardize this test.

The Usefulness of Bayley Scale of Infant Development II in the Diagnosis of Cerebral Palsy

OBJECTIVE: To evaluate the usefulness of Bayley scale of infant development, 2nd (BSID-II) in the diagnosis of cerebral palsy (CP) among the early childhood with delayed development. METHOD: We performed the BSID-II for children with delayed development who were diagnosed as CP or global developmental delay (GDD). The characteristics of mental developmental index (MDI) and psychomotor developmental index (PDI) of BSID-II were evaluated and sensitivity and specificity of BSID-II in the diagnosis of CP were studied. RESULT: While both MDI and PDI were decreased similarly in the GDD, PDI were significantly more decreased than MDI in the CP. The CP with hemiplegic pattern showed high MDI and PDI compared to those with the other patterns. When abnormal PDI defined as lower than 85 was used as a diagnostic criteria of CP, sensitivity and specificity were 0.88 and 0.41. When abnormal PDI defined as 13 and higher than MDI was used, sensitivity and specificity for the diagnosis of CP were 0.50 and 0.84. CONCLUSION: The characteristic findings of BSID-II in the CP could be used as a supportive diagnostic measurement. We should interpret carefully in the children with hemiplegic pattern because they had a near normal MDI and higher PDI than functional status of hemiplegic limbs.

Effect of Seizure Disorders on Developmental Disability in Patients with Cerebral Palsy or Delayed Development

OBJECTIVE: To investigate the effect of epilepsy and neonatal seizure on development in children with cerebral palsy (CP) or delayed development (DD). METHOD: The subjects were 135 patients with CP or DD. Development was evaluated by Bayley Scale of Infant Development II (BSID II). Epilepsy was diagnosed on the base of clinical features, past history and electroencephalography. RESULTS: The incidence of epilepsy was 18.4% in CP, and 37.8% in DD. Spastic quadriplegia of CP has the highest incidence of epilepsy (38.4%). First seizure attack was occurred before 6 months old of age in 66.7% of CP with epilepsy and in 64.3% of DD with epilepsy. The prevailing type of epilepsy was generalized seizure in DD (57.1%), partial seizure in CP (50.0%). The group with epilepsy had lower psychomotor and mental development quotient on BSID II than the group without epilesy (p<0.05). Polytherapy was more used to control epilepsy than monotherapy. Valproate (50.0%), phenobarbital (37.5%), carbamazepine (31.3%) were commonly used drugs for controlling epilepsy. CONCLUSION: The epilpesy has a negative effect on psychomotor and mental development in the children with CP or DD.

Relationship of Perinatal Risk Factors and Neonatal Complications with Bayley Scales in Asphyxiated Newborns

PURPOSE: Prediction of developmental outcome after perinatal asphyxia is important but difficult. The objective was to evaluate the relationship of perinatal risk factors and neonatal complications with Bayley Scales of Infant Development II (BSID-II) scores in asphyxiated newborns. METHODS: Forty asphyxiated infants, admitted between January and December 1997, were studied at a mean corrected age of 12.7 months. Perinatal risk factors, neonatal complications and developmental outcome were evaluated. Subjects were classified by BSID-II scores: 23 infants with normal development [Mental Developmental Index(MDI) and Psychomotor Developmental Index(PDI) > or =85] in Group 1, and 17 with delayed outcome(MDI or PDI or =70), and Group2B 7 with significant delay(MDI or PDI < or =70)]. RESULTS: MDI and PDI in Groups 1 and 2 were 98.97.0 and 108.4+/-10.1 vs. 79.3+/-16.2 and 79.5+/-22.6, respectively. MDI and PDI of Groups 2A and 2B were 85.7+/-11.4 and 94.215.7 vs.8.4 and 58.6+/-11.0, respectively. There were no significant differences in Apgar score, fetal deceleration, seizure, meconium aspiration, pH, BE, pCO2, LDH, CPK, CPK isoenzymes, EE(and brain ultrasonographic findings between Groups 1 and 2. But ultrasonographic findings were significantly different between Groups 1 and 2B. CONCLUSION: There was no significant difference of perinatal risk factors or neonatal complications between normal and delayed developmental groups by Bayley scales in asphyxiated newborns.